Fifa Football World Cup Now Has Water Breaks Hydration

the local weather or temperature conditions.

Earlier, hydration breaks were generally at the discretion of the match referee or at certain temperature thresholds; this is the first time that these breaks have been made mandatory. This measure is in view of the likely heat stress in the hot and humid weather in the venues and is termed by FIFA as “prioritising player welfare” in “a focused attempt to ensure the best possible conditions for players.”

A key driver of this decision was the forecast by the National Oceanic and Atmospheric Administration (NOAA) of the risk of extreme heat in some venues that had doubled since the United States last hosted the FIFA World Cup in 1994.

Equally critical was the experience of the FIFA Club World Cup in the USA, exactly a year ago. Coaches had reported calling off training sessions in Philadelphia on account of a “code red” heat warning. Players had reported feeling “really dizzy” while playing in temperatures described as “very dangerous.” Worryingly, the matches were played at a time when local weather warnings urged communities to avoid strenuous outdoor physical activities.

This mandatory hydration break has come under criticism, though, on account of its commercialisation as an additional opportunity for advertising. But hydration breaks, particularly during the heat season, have a much wider application beyond sports as a critical and enabling personal protection measure.

Hydration protocols have long been a core component of military training and practice. It dates back to advisories during the World Wars, to drinking water mixed with salt, but quantity and frequency were not specified. Current standardised protocols draw upon pioneering work done in this field by the US Marine Corps, in conjunction with the Army and Navy. The updated 2025 guidelines emphasise scheduling water breaks and optimising consumption. It recommends planning drinking opportunities during rests and cooling periods.

This is a major concern for India’s very large outdoor work force, an estimated 231.5 million workers, that is, 49.4 per cent, including those employed in agriculture (the non-farm workforce is about 18 per cent), based upon analyses of the Periodic Labour Force Survey. Even about 10 per cent of blue-collar workers in sectors such as trade, hotel, transport, storage and communication also work substantially outdoors, as do large numbers of those in public services such as the police, healthcare and other social sectors.

Hydration advisories for these occupational groups include drinking water regularly before, during and after work, with the water temperature ideally maintained at 10°C. Very cold water and ice slushies have limited effectiveness during work and are less palatable, resulting in less consumption. There is an urgent need for institutionalising mandatory water breaks for these diverse groups.

Hydration breaks are an important preventive measure for children in schools and Anganwadi Centres (Integrated Child Development Services units). Infants and young children have specific heat-related physiological and behavioural vulnerabilities since they produce more heat per kilogram of body weight. Children tend to spend a lot of time outdoors and inadequately replenish fluid loss sustained during prolonged exposure and playing, leading to exertional heat illnesses.

Hydration breaks, therefore, constitute an important school intervention for the prevention of heat-related illness. Kerala introduced the “water bell” system as early as 2019, when bells are rung twice a day at 10.30 am and 2.30 pm to remind children to drink adequate water. This was later taken up to a varying extent in Karnataka, Tamil Nadu and Telangana but not pursued very systematically. The practice was revived with greater seriousness in Kerala in 2024.

Heat Action Plans do emphasise both rest breaks and drinking water for vulnerable groups. Mandatory hydration breaks in schools and workplaces, however, are an evidence-based intervention that merits urgent attention.

The writer is Chairperson, Centre of Social Medicine and Community Health, JNU, and a collaborator in the Wellcome Trust-supported ‘Economic and Health Impact Assessment of Heat Adaptation Action: Case studies from India’. Views are personal